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1.
Medicina (B.Aires) ; 81(5): 840-842, oct. 2021. graf
Article in Spanish | LILACS | ID: biblio-1351036

ABSTRACT

Resumen Se describe el caso de una paciente de 27 años que se presentó al servicio de urgencias por hipoestesia y parestesia de dos meses de evolución. El cuadro se inició en ambos pies, progresó en pocos días hasta las rodillas sin trastornos de la marcha y se acompañó de distonías en pulgar e índice de ambas manos. La analítica sanguínea incluyendo tóxicos fue negativa. La resonancia magnética medular mostró una imagen sugestiva de mielopatía o mielitis (C3-C5) sin otras anomalías sugestivas de enfermedad sistémica. El análisis bioquímico y el bacteriológico del líquido cefalorraquídeo fueron normales. Ante estos elementos se re-interrogó a la paciente en busca de consumo de tóxicos inusuales con la confirmación de consumo de óxido nitroso. La paciente fue internada para la realización de otros estudios que confirmaron la hipótesis diagnóstica del servicio de urgencias.


Abstract We describe the case of a 27-year-old female patient who presented to the emergency ward with hypoesthesia and paresthesia developing over the last two months, initially in both feet and progressing to the knees in a few days without associated gait disorders. Dystonia in the thumb and index finger of both hands was noted. Blood tests including toxic drugs were negative. The spinal magnetic resonance imaging was consistent with (C3-C5) myelopathy or myelitis without other abnormalities suggestive of systemic diseases. The biochemi cal and bacteriological analysis of the cerebrospinal fluid was normal. Because of these findings, the patient was re-interviewed to determine the consumption of unusual drugs, and nitrous oxide consumption was referred. The patient was admitted for further studies, which confirmed the diagnosis.


Subject(s)
Humans , Female , Adult , Spinal Cord Diseases/chemically induced , Spinal Cord Diseases/diagnostic imaging , Nitrous Oxide/adverse effects , Magnetic Resonance Imaging
2.
Rev. colomb. anestesiol ; 49(2): e700, Apr.-June 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1251505

ABSTRACT

Cervical kyphoscoliosis is an uncommon spinal deformity. Kyphosis or outward curvature of cervical-spine (Image A) has led to a fixed flexion state resulting in suspension of patient's head in the air while lying on the imaging table. Additionally, dextroscoliosis or rightward convexity of the cervical vertebral axis has resulted in a persistent leftward head tilt (Image B). Head and neck radiation and trauma can lead to cervical kyphoscoliosis. In addition to the cosmetic deformity, patients present with myelopathic sensorimotor symptoms such as weakness and tingling of upper extremities. The Poisson effect states that flexion of the spine lengthens and stretches the spinal canal, reduces its area and narrows its lumen. This causes spinal cord impingement and myelopathy.


La cifoescoliosis cervical es una deformidad de la columna vertebral poco frecuente. La cifosis o la curvatura hacia fuera de la columna cervical (imagen A) ha dado lugar a un estado de flexión fija que provoca la suspensión de la cabeza del paciente en el aire mientras está tumbado en la mesa de diagnóstico por imagen. Además, la dextroscoliosis o convexidad hacia la derecha del eje vertebral cervical ha dado lugar a una inclinación persistente de la cabeza hacia la izquierda (Imagen B). La radiación de cabeza y cuello y los traumatismos pueden provocar cifoescoliosis cervical. Además de la deformidad estética, los pacientes presentan síntomas sensoriomotores mielopáticos como debilidad y hormigueo en las extremidades superiores. El efecto Poisson establece que la flexión de la columna vertebral alarga y estira el canal espinal, reduce su área y estrecha su lumen. Esto provoca el pinzamiento de la médula espinal y la mielopatía.


Subject(s)
Humans , Spinal Cord Diseases , Spine , Congenital Abnormalities , Paresthesia , Radiology , Spinal Canal , Cervical Vertebrae , Neck
3.
Coluna/Columna ; 20(2): 78-83, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1249663

ABSTRACT

ABSTRACT Objective: Cervical spondylotic myelopathy (CSM) is the main cause of spinal dysfunction in adults. The type of surgical approach to treatment is not well defined in the literature. The objective is to report the results obtained through isolated posterior decompression in patients with a previous indication of the combined approach for the treatment of cervical spondylotic myelopathy. Methods: This is a therapeutic study with level of evidence II, according to the Oxford classification table. Ten patients who underwent isolated posterior approach surgery for the treatment of cervical spondylotic myelopathy were evaluated through imaging and questionnaires (visual analog scale, mJOA-Br scale - Brazilian Portuguese version of the Modified Japanese Orthopedic Association Scale, and Neck Disability Index (NDI)), comparing pre- and postoperative results. Results: Late evaluation of the 10 patients was performed in the period ranging from 24 to 36 months (mean of 30.3 months ± 7.25) following surgery. The comparison of the clinical and radiological parameters in all patients showed a statistical difference in relation to the preoperative scales applied and to the degree of cervical lordosis (p <0.05), evidencing improvement after decompression and posterior fixation of the cervical spine. Conclusions: The isolated posterior approach (decompression, fixation and arthrodesis) allowed the clinical and radiological improvement of patients with cervical spondylotic myelopathy and who had an indication of the complementary anterior approach. Level of evidence II; Retrospective study.


RESUMO Objetivo: A mielopatia cervical espondilótica (MCE) é a principal causa de disfunção medular nos adultos. O tipo de abordagem cirúrgica para o tratamento não é bem definido na literatura. O objetivo é relatar os resultados obtidos por meio da descompressão posterior isolada nos pacientes com indicação prévia da abordagem combinada para o tratamento da mielopatia cervical espondilótica. Métodos: Trata-se de um estudo terapêutico com nível de evidência II, conforme a tabela de classificação Oxford. Dez pacientes submetidos apenas à abordagem cirúrgica posterior para tratamento de mielopatia cervical espondilótica foram avaliados por meio de exames de imagem e de questionários (escala visual analógica, escala mJOA-Br - Versão em Português da Escala Modificada da Sociedade Japonesa de Ortopedia e escala de incapacidade cervical - Neck Disability Index - NDI), comparando os resultados pré e pós-operatórios. Resultados: A avaliação tardia dos 10 pacientes foi realizada no período que variou de 24 a 36 meses (média de 30,3 meses ± 7,25) de pós-operatório. A comparação dos parâmetros clínicos e radiológicos em todos os pacientes mostrou diferença estatística com relação ao pré-operatório para as escalas aplicadas e para o grau de lordose cervical (p < 0,05), evidenciando a melhora depois da descompressão e da fixação posterior da coluna cervical. Conclusões: A abordagem posterior isolada (descompressão, fixação e artrodese) permitiu a melhora clínica e radiológica de pacientes com mielopatia cervical espondilótica e que tinham indicação da abordagem anterior complementar. Nível de evidência II; Estudo retrospectivo.


RESUMEN Objetivo: La mielopatía cervical espondilótica (MCE) es la principal causa de disfunción medular en los adultos. El tipo de abordaje quirúrgico para el tratamiento no está bien definido en la literatura. El objetivo es relatar los resultados obtenidos por medio de la descompresión posterior aislada en los pacientes con indicación previa del abordaje combinado para el tratamiento de la mielopatía cervical espondilótica. Métodos: Se trata de un estudio terapéutico con nivel de evidencia II, conforme a la tabla de clasificación Oxford. Diez pacientes sometidos únicamente al abordaje quirúrgico posterior para el tratamiento de la mielopatía cervical espondilótica fueron evaluados mediante exámenes de imagen y cuestionarios (escala analógica visual, escala mJOA-Br - versión en portugués de la escala modificada de la Sociedad Japonesa de Ortopedia y escala de incapacidad cervical - Neck Disability Index - NDI), comparando los resultados pre y postoperatorios. Resultados: La evaluación tardía de los 10 pacientes fue realizada en el período que varió de 24 a 36 meses (promedio de 30,3 meses ± 7,25) de postoperatorio. La comparación de los parámetros clínicos y radiológicos en todos los pacientes mostró diferencia estadística con relación al preoperatorio para las escalas aplicadas y para el grado de lordosis cervical (p <0,05), evidenciando la mejora después de la descompresión y de la fijación posterior de la columna cervical. Conclusiones: El abordaje posterior aislado (descompresión, fijación y artrodesis) permitió la mejora clínica y radiológica de pacientes con mielopatía cervical espondilótica y que tenían indicación del abordaje anterior complementario. Nivel de evidencia II; Estudio retrospectivo.


Subject(s)
Humans , Spinal Osteophytosis , Spinal Cord Diseases , Cervical Vertebrae
5.
Article in Chinese | WPRIM | ID: wpr-888332

ABSTRACT

OBJECTIVE@#To study the changes of anterior soft tissue swelling after anterior cervical subtotal corpectomy, titanium mesh fusion and internal fixation.@*METHODS@#From November 2015 to July 2018, 151 patients with cervical spondylotic myelopathy were treated with anterior single corpectomy, titanium mesh fusion and internal fixation, including 109 males and 42 females, aged 44 to 81 (59.77±8.34) years. Through postoperative follow up observation, the C@*RESULTS@#All patients were followed up for 15 to 40(28.00±3.52) months. One week after the operation, the swelling of anterior soft tissue reached the peak, and then decreased. At 8 months after the operation, the swelling of anterior soft tissue on C@*CONCLUSION@#Anterior subtotal cervical corpectomy, titanium mesh bone graft fusion and internal fixation can cause swelling of the anterior soft tissue. One week after operation, we should pay more attention to the aggravation of the swelling of the anterior soft tissue to avoid the occurrence of dysphagia, respiratory obstruction, asphyxia and other complications.


Subject(s)
Cervical Vertebrae/surgery , Female , Humans , Male , Retrospective Studies , Spinal Cord Diseases , Spinal Fusion , Spondylosis , Treatment Outcome
6.
Article in Chinese | WPRIM | ID: wpr-879437

ABSTRACT

OBJECTIVE@#To compare the efficacy of microscope assisted anterior cervical discectomy and fusion with conventional surgical approach in the treatment of single-segment cervical spondylotic myelopathy.@*METHODS@#The clinical data of 89 patients with single-segment cervical spondylotic myelopathy treated from March 2015 to March 2019 were retrospectively analyzed. There were 55 males and 34 females, with an average of (52.00±11.36) years old. Among the patients, 34 cases were treated with conventional anterior cervical discectomy with fusion (conventional group), including C@*RESULTS@#Intraoperative blood loss and hospital stay in microscope group were less than those in conventional group (@*CONCLUSION@#Both methods can achieve satisfactory effect in treating single-segment cervical spondylotic myelopathy. However, microscope-assisted anterior cervical discectomy and fusion has advantages of clear vision, less bleeding and fewer intraoperative complications.


Subject(s)
Adult , Cervical Vertebrae/surgery , Diskectomy , Female , Humans , Male , Middle Aged , Retrospective Studies , Spinal Cord Diseases/surgery , Spinal Fusion , Spondylosis/surgery , Treatment Outcome
7.
Rev. argent. neurocir ; 34(4): 289-299, dic. 2020. ilus, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1150438

ABSTRACT

Introducción: la fístula dural arteriovenosa espinal (FDAVE) es una enfermedad vascular rara, de etiología desconocida y frecuentemente subdiagnosticada. El tratamiento puede ser microquirúrgico o endovascular. Material y Método: Análisis retrospectivo de una serie de 8 pacientes consecutivos con FDAVE tratados por microcirugía entre 2010 y 2020. Fueron evaluados parámetros como edad, sexo, cuadro clínico pre y postoperatorio medido con las escalas de Aminoff-Logue y Rankin modificada. Los estudios diagnósticos con RMN (Resonancia Magnética Nuclear), ARM (Angio Resonancia Magnética) y ADM (Angiografía Digital Medular) se utilizaron para determinar nivel lesional y resultados quirúrgicos. Resultados: Fueron operados 8 pacientes (7 masculinos y 1 femenino) con un promedio de edad de 58 años. El tiempo de evolución del cuadro clínico al diagnóstico fue menor a 12 meses salvo un caso de 32 meses. Las FDAVE fueron localizadas en: 6 a nivel dorsal entre D6 y D12, una en L2 y la última en S1 (5 derechas y 3 izquierdas). La arteria de Adamkiewicz se identificó en: 4 casos en L1, 2 en D12, 1 en D10 y un caso en D7 (6 izquierdas y 2 derechas). De los 8 pacientes operados, 3 fueron embolizados previamente. La evolución postoperatoria del cuadro neurológico fue: 2 de 8 permanecieron estables y 6 de 8 mejoraron uno o más puntos en la escala de Rankin modificada; no hubo complicaciones en el postoperatorio. Todos los pacientes mejoraron las imágenes en RMN diferida y la ADM luego de los 6 meses fue negativa. El seguimiento promedio fue de 48 meses con un rango de 11 a 116 meses, ningún paciente presentó recidiva de la FDAVE. Conclusiones: El tratamiento quirúrgico de las FDAVE es un método muy eficaz, de baja morbilidad y menor tasa de recurrencia comparado con el tratamiento endovascular.


Introduction: Spinal dural arteriovenous fistula (SDAVF) is a rare vascular disease, of unknown etiology and frequently underdiagnosed. Treatment can be microsurgical or endovascular. Material and Method: Retrospective analysis of a series of 8 SDAVF patients treated by microsurgery between 2010 and 2020. Parameters including age, sex, pre and postoperative clinical condition were analyzed according to modified Aminoff-Logue and modified Rankin scales. Diagnostic studies such as MRI (Magnetic Resonance Imaging), MRA (Magnetic Resonance Angiogram) and spinal DSA (Digital Subtraction Angiography), were evaluated for lesion level, as were surgical results. Results: Eight patients (7 male and 1 female), average age of 58 years were operated. The interval from symptom onset to diagnosis was less than 12 months in all cases except one (32 months). SDAVF locations were thoracic in 6 cases between T6 and T12, at L2 in one and at S1 in one case (5 on the right and 3 on the left). The Adamkiewicz artery was identified in: 4 cases at L1, 2 at D12, 1 at D10 and in one case at D7 (6 left-sided and 2 right-sided). Three of the 8 patients operated had undergone prior embolization. Postoperative neurological outcomes showed: 2 patients remained stable and 6 had improved one or more points on the modified Rankin scale; no postoperative complications were observed. Follow-up MRI images improved in all cases and spinal DSA was negative at six months. Average follow-up was 48 months (range 11 to 116 months), no patient presented recurrence. Conclusions: Microsurgical treatment of SDAVF proved to be efficient, with low morbidity and lower recurrence rates compared to endovascular results.


Subject(s)
Humans , Fistula , Spinal Cord Diseases , Vascular Diseases , Angiography , Central Nervous System Vascular Malformations , Microsurgery
8.
Rev. bras. ortop ; 55(6): 796-799, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1156192

ABSTRACT

Abstract Gout is a crystalline arthropathy frequent in the population, but gouty spondyloarthropathy, also called axial gout, is uncommon. The current case report presents a rare case of cervical myelopathy secondary to axial gout. A 50-year-old female patient, without previous pathologies, presented with loss of strength, altered sensitivity, and pyramidal release for 2 years. The computed tomography showed a lytic image in the spinous process of C7, and signs of myelopathy with myelomalacia on magnetic resonance imaging of the cervical spine. After the surgical procedure and biopsy of the material, the diagnosis was gout, and treatment for the pathology was started, with complete improvement of the condition. The diagnosis of axial gout should be included in the spectrum of the differential diagnosis of diseases that affect the spine. Although gouty spondyloarthritis (or spondylitis) is uncommon, there is an underestimated occurrence due to the lack of investigation of the cases. The early diagnosis and treatment of the pathology can prevent patients from presenting complications of the disease, as reported in the present study.


Resumo A gota é uma artropatia cristalina frequente na população; entretanto, a espondiloartropatia gotosa, também chamada de gota axial, é incomum. O presente relato de caso apresenta um caso raro de mielopatia cervical secundária a gota axial. Uma paciente de 50 anos de idade, sem patologias prévias, apresentou quadro de perda de força, alteração de sensibilidade e liberação piramidal há 2 anos. A tomografia computadorizada evidenciou imagem lítica no processo espinhoso de C7, e sinais de mielopatia com mielomalácia foram observados na ressonância magnética da coluna cervical. Após o procedimento cirúrgico e biópsia do material, o diagnóstico foi de gota, e o tratamento para a patologia foi iniciado, com melhora completa do quadro. O diagnóstico de gota axial deve ser incluído no espectro do diagnóstico diferencial das doenças que acometem a coluna vertebral. Apesar de a espondiloartrite gotosa ser incomum, há uma ocorrência subestimada devido a não investigação dos casos. O diagnóstico precoce e tratamento da patologia pode evitar que pacientes apresentem complicações da doença, como a relatada no presente estudo.


Subject(s)
Humans , Female , Middle Aged , Spinal Cord Compression , Spinal Cord Diseases , Biopsy , Magnetic Resonance Imaging , Magnetic Resonance Spectroscopy , Paraparesis , Spondylarthropathies , Diagnosis, Differential , Triquetrum Bone , Gout , Joint Diseases
9.
Arq. bras. med. vet. zootec. (Online) ; 72(2): 339-345, Mar./Apr. 2020. ilus
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1128182

ABSTRACT

Objetivou-se descrever os achados clínicos, histopatológicos e moleculares associados à MDC em um cão da raça Pastor-Suiço. O cão possuía uma paraparesia progressiva em membros pélvicos e foi submetido a avaliações clínicas, pelas quais se obteve, entre outros diferenciais, o diagnóstico presuntivo de MDC. Com a evolução dos sinais, o tutor optou pela eutanásia. Os achados histopatológicos da medula espinhal foram compatíveis com uma degeneração segmentar axonal e mielínica. O diagnóstico molecular foi realizado por meio da extração do DNA obtido por swab oral. Uma PCR foi otimizada utilizando-se primers descritos em literatura para amplificar a região do gene SOD1. A amostra foi, então, submetida a sequenciamento unidirecional, que revelou que o animal em questão era homozigoto para o alelo A para a mutação c.118G>A no éxon 2 do gene SOD1. O diagnóstico clínico presuntivo da MDC no presente caso foi esclarecido por meio dos achados histopatológicos, associados aos achados clínicos, e da sua caracterização molecular. Ressalta-se a contribuição deste relato, que traz aspectos clínicos, histopatológicos e moleculares associados à MDC na raça Pastor-Suíço, para a qual, até o presente momento, na literatura consultada, não há relato dessa enfermidade.(AU)


The objective of this study was to describe the clinical, histopathological and molecular findings associated with MDC in a Swiss Shepherd dog. The dog had a progressive paraparesis in pelvic limbs and was submitted to clinical evaluations where, among other differentials, the presumptive diagnosis of MDC was obtained. With the progression of the nervous deficits tutor opted for euthanasia. The histopathological findings of the spinal cord were compatible with axonal and myelinic segmental degeneration. Molecular diagnosis was performed by extracting the DNA obtained by oral swab. PCR was optimized using primers described in the literature to amplify the SOD1 gene region. The sample was then subjected to one-way sequencing which revealed that the animal in question was homozygous for the A allele for the c.118G>A mutation in exon 2 of the SOD1 gene. The presumptive diagnosis of MDC in the present case was clarified by histopathological findings, as well as by its molecular characterization. The contribution of this report brings clinical, histopathological and molecular aspects associated with canine degenerative myelopathy in the Swiss Shepherd breed, that until this moment, in the literature consulted, there is no report of this disease in the breed mentioned.(AU)


Subject(s)
Animals , Female , Dogs , Spinal Cord Diseases/pathology , Spinal Cord Diseases/veterinary , Neurodegenerative Diseases/veterinary , Superoxide Dismutase-1 , Amyotrophic Lateral Sclerosis/veterinary , Polymerase Chain Reaction
10.
Fisioter. Mov. (Online) ; 33: e003303, 2020. tab, graf
Article in English | LILACS | ID: biblio-1056178

ABSTRACT

Abstract Introduction: Postural control in individuals with HTLV-1-associated myelopathy or tropical spastic paraparesis (HAM/TSP) is usually compromised, which increases the risk of falls, makes it difficult to perform activities of daily living, and impairs the quality of life. The profile of the center of gravity oscillations in this population is unknown and may aid in clinical follow-up and research. Objective: To compare the stabilometric values between HAM/TSP and uninfected individuals and verify the existence of correlations between stabilometric variables and the Berg Balance Scale (BBS). Method: A cross-sectional observational study was performed with infected individuals, classified as defined and likely (WHO criteria), compared to accompanying persons and seronegative relatives. A baropodometry platform (Footwork®) was used to obtain the oscillation values of the body's center of gravity in total oscillation area (TOA), anterior-posterior oscillation (APO) and lateral oscillation (LO). Mean values were correlated with BBS by Spearman's Correlation (5% alpha). Approved by the ethical committee of Escola Bahiana de Medicina e Saúde Pública under Opinion 49634815.2.0000.5628. Results: An asymmetric distribution of all the stabilometric variables analyzed in the HAM/TSP population was found, different from the uninfected group (p < 0.05). It was also possible to verify strong to moderate and inverse correlations between the variables of center of gravity oscillation with the scores obtained in BBS, especially for TOA and LO. Conclusion: People with HAM/TSP presented higher values for the center of gravity oscillations and these were correlated with the BBS in the balance evaluation.


Resumo Introdução: o controle postural em indivíduos com mielopatia associada ao HTLV-1 ou paraparesia espástica tropical (HAM/TSP) é geralmente comprometido, o que aumenta o risco de quedas, dificulta a realização de atividades de vida diária e prejudica a qualidade de vida. O perfil das oscilações do centro de gravidade nesta população é desconhecido e pode auxiliar no acompanhamento clínico e na pesquisa. Objetivo: comparar os valores estabilométricos entre pessoas com HAM/TSP e não infectados, e verificar a existência de correlações entre variáveis estabilométricas e a Escala de Equilíbrio Berg (EEB). Método: foi realizado um estudo observacional transversal com indivíduos infectados, classificados como definidos e prováveis (critérios da OMS), comparados com acompanhantes e familiares soronegativos. Uma plataforma de baropodometria (Footwork®) foi utilizada para obter os valores de oscilação do centro de gravidade do corpo em área de oscilação total (AOT), oscilação anteroposterior (OAP) e oscilação laterolateral (OLL). Os valores médios foram correlacionados com a BBS pela Correlação de Spearman (alfa 5%). Aprovado pelo Comitê de Ética da Escola Bahiana de Medicina e Saúde Pública sob o CAAE 49634815.2.0000.5628. Resultados: encontrou-se distribuição assimétrica de todas as variáveis estabilométricas analisadas na população com HAM/TSP, diferentes do grupo de não infectados (p < 0,05). Também foi possível verificar correlações de forte a moderada e inversas entre as variáveis de oscilação do centro de gravidade com os escores obtidos na EEB, especialmente para AOT e OLL. Conclusão: Pessoas com HAM/TSP apresentaram valores maiores para as oscilações do centro de gravidade e estas foram correlacionadas com a EEB na avaliação do equilíbrio.


Resumen Introducción: El control postural en individuos con mielopatía asociada al HTLV-1 o paraparesia espástica tropical (HAM/TSP) suele estar comprometido, lo que aumenta el riesgo de caídas, les dificulta en las actividades de la vida diaria y perjudica su calidad de vida. Conocer el perfil de las oscilaciones del centro de gravedad en esta población puede ayudar en el seguimiento clínico y la investigación. Objetivo: Comparar los valores estabilométricos entre personas con HAM/TSP y personas no infectadas, y verificar la existencia de correlaciones entre las variables estabilométricas y la Escala de Equilibrio de Berg (BBS). Método: Se realizó un estudio observacional transversal con individuos infectados, clasificados como definidos y probables (criterios de la OMS), comparados a acompañantes y familiares seronegativos. Se utilizó una plataforma de baropodometría (Footwork®) para obtener los valores de oscilación del centro de gravedad del cuerpo en el área de oscilación total (AOT), oscilación antero-posterior (OAP) y oscilación lateral-lateral (OLL). Los valores medios se correlacionaron con la BBS por la correlación de Spearman (alfa 5%). Estudio aprobado por el Comité de Ética de la Escuela Bahiana de Medicina y Salud Pública bajo CAAE 49634815.2.0000.5628. Resultados: Se encontró una distribución asimétrica de todas las variables estabilométricas analizadas en la población HAM/TSP diferente en el grupo no infectado (p <0,05). También fue posible verificar correlaciones de fuertes a moderadas e inversas entre las variables de oscilación del centro de gravedad con las puntuaciones obtenidas en la BBS, especialmente para AOT y OLL. Conclusión: Las personas con HAM/TSP presentaron valores más altos en las oscilaciones del centro de gravedad, las cuales se correlacionaron con la BBS en la evaluación del equilibrio.


Subject(s)
Humans , Middle Aged , Spinal Cord Diseases , Human T-lymphotropic virus 1 , Postural Balance , Paraparesis, Tropical Spastic , Automatic Control of Processes , Motor Activity
11.
Rev. bras. parasitol. vet ; 29(1): e014619, 2020. graf
Article in English | LILACS | ID: biblio-1058010

ABSTRACT

Abstract Parasitic myelopathy caused by Gurltia paralysans in domestic cats is a disease commonly reported in several South American countries. The adult parasite is lodged in the meningeal veins and spinal cord, often causing clinical manifestations of vascular proliferation, thrombophlebitis, and medullary compression. Wild felines are believed to be the definitive hosts of this parasite. The infection occurs through the ingestion of paratenic hosts, but the life cycle of G. paralysans is not yet clearly understood. In this paper, we discuss a case of parasitic myelopathy in a margay (Leopardus wiedii) that died during post-surgical care. Necropsy revealed focal hemorrhages in the thoracolumbar spinal cord. A microscopic examination revealed adult nematodes and eggs inside the veins of subarachnoid space in spinal cord, suggesting G. paralysans infection. This is first description of parasitic myelopathy in a margay in Brazil.


Resumo Mielopatia parasitária causada por Gurltia paralysans em gatos domésticos é uma doença comumente relatada em vários países da América do Sul. O parasita adulto aloja-se nas veias das meninges e da medula espinhal, muitas vezes causando proliferação vascular, tromboflebite e compressão medular, que se manifestam como sinais clínicos. Acredita-se que os felídeos selvagens sejam hospedeiros definitivos deste parasita e que a infecção ocorre por ingestão de hospedeiros paratênicos, entretanto seu ciclo de vida completo é desconhecido. Aqui, apresentamos um caso de um gato-maracajá (Leopardus wiedii) que morreu durante a assistência pós-cirúrgica. Na necropsia, foram observadas hemorragias focais na medula espinhal toracolombar. A microscopia revelou presença de nematódeos adultos e ovos, localizados dentro das veias do espaço subaracnoide da medula espinhal, o que sugeriu a infecção por G. paralysans. Esta é a primeira descrição de mielopatia parasitária em um gato-maracajá no Brasil.


Subject(s)
Animals , Cats , Spinal Cord Diseases/parasitology , Felidae/classification , Nematoda/isolation & purification , Nematode Infections/veterinary , Spinal Cord Diseases/diagnosis , Brazil , Felidae/parasitology , Animals, Wild , Nematoda/classification , Nematode Infections/diagnosis , Nematode Infections/parasitology
12.
Chinese Medical Journal ; (24): 2816-2821, 2020.
Article in English | WPRIM | ID: wpr-877937

ABSTRACT

BACKGROUND@#The optimal surgical approach for four-level cervical spondylotic myelopathy remains controversial. The purpose of this study was to compare clinical and radiological outcomes and complications between the anterior and posterior approaches for four-level cervical spondylotic myelopathy.@*METHODS@#A total of 19 patients underwent anterior decompression and fusion and 25 patients underwent posterior laminoplasty and instrumentation in this study. Perioperative information, intraoperative blood loss, clinical and radiological outcomes, and complications were recorded. Japanese Orthopedic Association (JOA) score, 36-item short form survey (SF-36) score and cervical alignment were assessed.@*RESULTS@#There were no significant differences in JOA scores between the anterior and posterior group preoperatively (11.6 ± 1.6 vs. 12.1 ± 1.5), immediately postoperatively (14.4 ± 1.1 vs. 13.8 ± 1.3), or at the last follow-up (14.6 ± 1.0 vs. 14.2 ± 1.1) (P > 0.05). The JOA scores significantly improved immediately postoperatively and at the last follow-up in both groups compared with their preoperative values. The recovery rate was significantly higher in the anterior group both immediately postoperatively and at the last follow-up. The SF-36 score was significantly higher in the anterior group at the last follow-up compared with the preoperative value (69.4 vs. 61.7). Imaging revealed that there was no significant difference in the Cobb angle at C2-C7 between the two groups preoperatively (-2.0° ± 7.3° vs. -1.4° ± 7.5°). The Cobb angle significantly improved immediately postoperatively (12.3° ± 4.2° vs. 9.2° ± 3.6°) and at the last follow-up (12.4° ± 3.5° vs. 9.0° ± 2.6°) in both groups compared with their preoperative values (P = 0.00). Three patients had temporary dysphagia in the anterior group and four patients had persistent axial symptoms in the posterior group.@*CONCLUSIONS@#Both the anterior and posterior approaches were effective in treating four-level cervical spondylotic myelopathy in terms of neurological clinical outcomes and radiological features. However, the JOA score recovery rate and SF-36 score in the anterior group were significantly higher. Persistent axial pain could be a major concern when undertaking the posterior approach.


Subject(s)
Blood Loss, Surgical , Cervical Vertebrae/surgery , Decompression, Surgical , Humans , Laminoplasty , Retrospective Studies , Spinal Cord Diseases/surgery , Spinal Fusion , Spondylosis/surgery , Treatment Outcome
13.
Article in Chinese | WPRIM | ID: wpr-828283

ABSTRACT

OBJECTIVE@#To explore the clinical efficacy and safety of posterior intervertebral foraminal discectomy via Delta channel for cervical spondylotic radiculopathy in the early phase.@*METHODS@#From September 2017 to July 2018, 10 patients with cervical spondylotic radiculopathy underwent posterior intervertebral foraminal discectomy via Delta channel. There were 6 males and 4 females, aged from 30 to 62 years old with an average of (41.5±4.3) years old. All of them had unilateral symptoms caused by cervical nerve root compression, including 2 cases of C, 5 cases of C and 3 cases of C. CT and MRI examination of all the patients did not show ossification of posterior longitudinal ligament or calcification of ligamentum flavum, and no cervical spine instability was present in dynamic radiographs. The clinical outcome was poor after more than 6 weeks of systematic non-surgical treatment. The VAS score, JOA score, NDI score, the cervical spine physiological curvature, and the height and stability of the compressed cervical vertebrae were measured before operation and at the latest follow-up.@*RESULTS@#All patients successfully completed the surgeries without any spinal cord, nerve root or major blood vessel injury. The operation time was 70 to 120 min with an average of 90 min. Intraoperative blood loss ranged from 30 to 90 ml with an average of 40 ml. All the 10 patients were followed up for 6 to 14 months with an average of 9 months. Postoperative nerve root pain got relievd and nerve function was improved in all patients. VAS score decreased from 7.15±2.01 before surgery to 1.59±0.83 at the latest follow-up;JOA score increased from 12.57±1.24 before surgery to 16.42±0.58 at the latest follow-up;NDI score increased from 41.82±4.71 before surgery to 9.59±3.52 at the latest follow-up. All the results above presented significant difference between latest follow-up and preoperative (0.05). At the latest follow-up, no cervical instability was observed on dynamic radiographs.@*CONCLUSION@#Treatment of cervical spondylotic radiculopathy by posterior intervertebral foraminal discectomy via Delta channel can obtain a satisfactory clinical outcome without affecting the stability of cervical vertebra. The surgery is safe, reliable and worthy of clinical application.


Subject(s)
Adult , Cervical Vertebrae , Diskectomy , Female , Humans , Male , Middle Aged , Radiculopathy , Retrospective Studies , Spinal Cord Diseases , Spinal Fusion , Spondylosis , Treatment Outcome
14.
Article in Chinese | WPRIM | ID: wpr-827246

ABSTRACT

OBJECTIVE@#To explore the clinical effects of anterior cervical discectomy with fusion (ACDF) and anterior cervical corpectomy with fusion (ACCF) in treating adjacent two-segment cervical spondylotic myelopathy (CSM).@*METHODS@#The clinical data of 37 patients with adjacent two segment CSM treated from January 2016 to December 2017 were retrospectively analyzed, including 15 males and 22 females, aged from 43 to 69 years old with an average of 54.6 years. The patients were divided into ACDF group (group A, =17) and ACCF group (group B, =20) according to the different surgery. The operation time and intraoperative blood loss were recorded;the Cobb angle and cervical curvature in the cervical fusion segments before surgery and 1, 12 months after surgery were observed;Japanese Orthopaedic Association (JOA) score was used to evaluate the surgical efficacy, and the postoperative complications were analyzed.@*RESULTS@#All patients were followed up for 12 to 24 months with an average of 18.5 months. Operation time and intraoperative blood loss in group A were (106.3±22.6) min, (52.2±26.4) ml, respectively, while were (115.6±16.8) min, ( 61.7±20.7) ml in group B. There was no statistically significant in operation time between two groups(>0.05);intraoperative blood loss in group B was larger than group A(0.05). At the final follow up, in group A, dysphagia occurred in 2 cases, cage displacement in 1 case, and no titanium plate screw loose was found;and in group B, dysphagia occurred in 4 cases, titanium mesh collapse in 2 cases, titanium plate screw loose in 1 case.@*CONCLUSION@#Two types of anterior cervical decompression and fusion for the treatment of two segment cervical spondylotic myelopathy can effectively decompress and improve the Cobb angle and cervical curvature of the affected vertebra. The ACDF surgical procedure can directly removethe compressive thing at intervertebral level, which will lead to little vertebral body damage and favorably recovered cervical curvature. The ACCF surgical procedure has a large operation space, which can easily remove the posterior vertebral osteophyte and the calcified posterior longitudinal ligament. Long-term follow-up shows that ACDF and ACCF have good surgical procedures, mature technology, and close efficacy.


Subject(s)
Adult , Aged , Cervical Vertebrae , General Surgery , Diskectomy , Female , Humans , Male , Middle Aged , Retrospective Studies , Spinal Cord Diseases , General Surgery , Spinal Fusion , Spondylosis , General Surgery , Treatment Outcome
16.
Rev Assoc Med Bras (1992) ; 66(4): 507-511, 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136219

ABSTRACT

SUMMARY INTRODUCTION Retro-odontoid pseudotumor (ROP) is a rare disease that affects the atlantoaxial joint and, in general, is associated with local biomechanical alterations that may or may not cause instability. METHODS Descriptive study of the literature available in databases MEDLINE/PubMed, LILACS, and Scopus. The research was conducted in April 2019. DISCUSSION ROP is, possibly, a syndromic designation that encompasses a significant variety of diseases of the atlantoaxial joint. There are different pathophysiological mechanisms implicated in its genesis. The patients, almost in their entirety, present with severe myelopathy, and most of them are treated surgically, with the posterior decompression being the most commonly used method, with or without arthrodesis. Evolution is usually favorable. CONCLUSION The ROP is still poorly recognized as a differential diagnosis between the diseases of the cranial-cervical junction. The information available in the literature analyzed was based mainly on the study of reports or case series; therefore, it is insufficient to define conducts with a high level of scientific evidence.


RESUMO INTRODUÇÃO O pseudotumor retro-odontoide (PRO) é uma patologia rara que acomete a articulação atlantoaxial e, em geral, está associada a alterações biomecânicas locais que podem ou não causar instabilidade. METODOLOGIA Estudo descritivo da literatura disponível nas bases de dados Medline/PubMed, Lilacs e Scopus. A pesquisa foi realizada em abril de 2019. DISCUSSÃO O PRO é, possivelmente, uma designação sindrômica que abrange uma variedade significativa de doenças da articulação atlantoaxial. Existem diferentes mecanismos fisiopatológicos implicados em sua gênese. Os pacientes, quase em sua totalidade, apresentam quadro de mielopatia grave e a maioria deles é tratada cirurgicamente, sendo a descompressão posterior o método mais utilizado, com ou sem artrodese. A evolução costuma ser favorável. CONCLUSÃO O PRO ainda é pouco reconhecido como diagnóstico diferencial entre as doenças da junção crânio-cervical. As informações disponíveis na literatura analisada foram baseadas principalmente no estudo de relatos ou séries de casos, sendo, portanto, insuficientes para definir condutas com alto nível de evidência científica.


Subject(s)
Humans , Atlanto-Axial Joint , Spinal Cord Diseases , Odontoid Process , Skull , Magnetic Resonance Imaging , Femur Neck
17.
Coluna/Columna ; 18(4): 327-329, Oct.-Dec. 2019. graf
Article in English | LILACS | ID: biblio-1055988

ABSTRACT

ABSTRACT Introduction: The main causative agent of spinal infections is Mycobacterium Tuberculosis, followed by saprophytes of the skin. The most affected segment is the lumbar, followed by the thoracic. Objective: Case report. Results: A previously healthy 40-year-old man with posterior cervical pain and myelopathy was referred to our spine service for vertebral destruction syndrome in C3-C4 and altered carbohydrate metabolism. Microdiscectomy and abscess drainage were performed and a biopsy was taken for definitive diagnosis. Multiresistant Serratia Marcescens was isolated in the culture. Both the myelopathy and carbohydrate intolerance were resolved as the infection was resolved. Conclusion: The significance of this case lies in the infective presentation of the S. Marcescens in an immunocompetent person, since it is mainly an opportunistic microorganism, and in the atypical location. The most commonly isolated pathogen is Mycobacterium Tuberculosis, followed by Staphylococcus aureus. Identification of the causative agent is essential to the initiation of antibiotic therapy. Therefore, microbiological isolation plays a fundamental role in the treatment, recovery and quality of life of the patient. Level of evidence V; Case report.


RESUMO Introdução: O principal agente causador das infecções da coluna vertebral é o Mycobacterium tuberculosis, seguido pelos saprófitos da pele. O segmento mais afetado é o lombar, seguido pelo torácico. Objetivo: Relato de caso. Resultados: Um homem, anteriormente saudável, de 40 anos, com dor cervical posterior e mielopatia como principal sintomatologia, foi encaminhado ao nosso serviço de coluna vertebral com síndrome de destruição vertebral em C3-C4 e alteração do metabolismo de carboidratos. A microdiscectomia e a drenagem de abscessos foram realizadas e uma biópsia foi feita para diagnóstico definitivo. A Serratia marcescens multirresistente foi isolada na cultura. Tanto a mielopatia como a intolerância a carboidratos foram resolvidas, uma vez que a infecção foi tratada. Conclusão: A importância desse caso reside na apresentação infecciosa da S. marcescens em uma pessoa imunocompetente, uma vez que esse é principalmente um microrganismo oportunista e por sua localização atípica. O patógeno mais comumente isolado é o Mycobacterium tuberculosis, seguido pelo Staphylococcus aureus. A identificação do agente causador é essencial para início da terapia com antibióticos. Portanto, o isolamento microbiológico desempenha um papel fundamental no tratamento, recuperação e qualidade de vida do paciente. Nível de evidência: V; Relato de caso.


RESUMEN Introducción: El principal agente causal de las infecciones de columna es la Mycobacterium Tuberculosis seguido de los saprófitos de la piel y el principal segmento afectado es el lumbar, seguido del torácico. Objetivo: Reporte de caso. Resultados: Presentamos un masculino de 40 años previamente sano, referido al servicio de columna por síndrome de destrucción vertebral C3-C4, con dolor cervical posterior y mielopatía como principal sintomatología, y alteración del metabolismo de carbohidratos. Se realizó microdiscectomía y drenaje de absceso con toma de biopsia para diagnóstico definitivo. En el cultivo se aisló Serratia Marcescens, multirresistente. La mielopatía y la intolerancia a los carbohidratos se resolvieron una vez resuelta la infección. Conclusión: La importancia de este caso radica en la presentación infectante de la S. Marcescens en una persona inmunocompetente ya que esta es principalmente un microorganismo oportunista y por su localización atípica. El patógeno más comúnmente aislado es Mycobacterium Tuberculosis seguido de Staphylococcus aureus. La identificación del agente causal es fundamental para iniciar la terapéutica antibiótica. Por lo tanto, el aislamiento microbiológico tiene un papel fundamental en el tratamiento, la recuperación y calidad de vida del paciente. Nivel de evidencia V; Reporte de caso.


Subject(s)
Humans , Serratia marcescens , Spinal Cord Diseases , Discitis
18.
Arq. bras. med. vet. zootec. (Online) ; 71(5): 1453-1458, set.-out. 2019. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1038653

ABSTRACT

Cases of compressive myelopathy syndrome associated with post vaccinal pyogranulomas were diagnosed post mortem in three cows from a farm in Minas Gerais state, Brazil. These cows presented ataxia and bilateral paresis of the pelvic limbs, which evolved to paralysis, and sternal recumbence. On necropsy, locally extensive areas of the longissimus dorsi muscle were replaced by pyogranulomas supported by moderate amounts of fibrous connective tissue. On the cut surface, some nodules contained yellowish and viscous fluid (purulent exudate) or whitish fluid (interpreted as the oily adjuvant of a vaccine). In the spinal canal of the subjacent vertebrae, compressing the spinal cord, were pyogranulomas identical to those described in the skeletal muscle. Histologically, the pyogranulomas were composed of a central clear vacuole (consistent with the space left by the oil adjuvant droplets), surrounded by neutrophils and, more externally, by large numbers of epithelioid macrophages and fewer multinucleated giant cells. In the white matter of the spinal cord were numerous well-defined, clear vacuoles (Wallerian degeneration). The association of the clinical history and pathological findings allowed the diagnosis of compressive myelopathy associated with pyogranulomatous reaction to the oily adjuvant of the foot-and-mouth disease vaccine, in this case, due to its inadequate application.(AU)


São descritos casos de síndrome de compressão medular, associada a granulomas pós-vacinais, em bovinos Nelore, provenientes de uma propriedade em Minas Gerais. Esses bovinos apresentavam ataxia e paresia bilateral dos membros pélvicos, que evoluiu para paralisia e decúbito esternal. Na necropsia, áreas focalmente extensas da musculatura na região torácica dorsal (músculo longissimus dorsi) eram substituídas por numerosos piogranulomas, separados por tecido brancacento e firme (tecido conjuntivo fibroso). Ao corte, alguns nódulos continham material amarelado e viscoso (exsudato purulento) ou material esbranquiçado e fluido (sugestivo de adjuvante de vacina). No canal medular das vértebras subjacentes, havia granulomas idênticos aos observados no tecido muscular. Histologicamente, os piogranulomas continham, no centro, vacúolo, bem delimitado e arredondado (consistente com o espaço deixado pela gotícula de lipídio do adjuvante), circundado por variável quantidade de neutrófilos degenerados e íntegros e, mais externamente, por numerosos macrófagos epitelioides e algumas células gigantes multinucleadas. Nas áreas da medula espinhal, circundadas pelos granulomas, numerosos vacúolos, bem definidos, eram observados na substância branca (degeneração walleriana). A associação do histórico clínico e de achados patológicos permitiu o diagnóstico de mielopatia compressiva associada à reação granulomatosa ao adjuvante oleoso da vacina contra febre aftosa, no caso, induzida pela aplicação inadequada da vacina.(AU)


Subject(s)
Animals , Female , Cattle , Spinal Cord Compression/chemically induced , Spinal Cord Compression/veterinary , Spinal Cord Diseases/veterinary , Vaccines/adverse effects , Foot-and-Mouth Disease/prevention & control , Nervous System Diseases/veterinary
19.
Rev. Hosp. Ital. B. Aires (2004) ; 39(3): 94-97, sept. 2019. ilus.
Article in Spanish | LILACS | ID: biblio-1048277

ABSTRACT

Las fístulas arteriovenosas durales medulares son malformaciones vasculares adquiridas que constituyen una causa muy infrecuente de mielopatía progresiva (5-10 casos por millón de habitantes por año). La resonancia magnética es el estudio por imágenes de elección para su diagnóstico. A continuación presentamos el caso de una paciente femenina de 89 años, que consultó a la guardia de nuestra institución por un cuadro de paraparesia moderada asociada a parestesias e incontinencia urinaria posterior a esfuerzo físico. Se le diagnosticó una fístula arteriovenosa dural medular como causante de su cuadro. (AU)


Spinal dural arteriovenous fistulas (SDAVF) are acquired spinal vascular malformations and a rare cause of progressive myelopathy (5-10 new cases per year and per 1 million inhabitants). Magnetic resonance imaging is the diagnosis modality of choice. We present a case of a 89-year-old female patient who consulted the emergency department of our institution because of paraparesis and lower extremities paresthesias associated with urinary incontinence post physical effort. With the final diagnosis of spinal dural arteriovenous fistula, as a cause of the clinical symptoms. (AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Arteriovenous Fistula/diagnostic imaging , Dura Mater/abnormalities , Paresthesia , Atrial Fibrillation/complications , Spinal Cord Diseases/diagnostic imaging , Tobacco Use Disorder/complications , Urinary Incontinence , Arteriovenous Fistula/etiology , Arteriovenous Fistula/epidemiology , Low Back Pain/complications , Aortic Aneurysm, Abdominal/complications , Paraparesis , Fecal Incontinence , Hypertension/complications , Hypesthesia , Erectile Dysfunction , Anticoagulants/therapeutic use
20.
Fisioter. Bras ; 20(4): 500-508, Set 3, 2019.
Article in Portuguese | LILACS | ID: biblio-1281547

ABSTRACT

Introdução: A esclerose múltipla (EM) é a mais comum das doenças desmielinizantes, caracterizada pela localização de múltiplas placas de desmielinização na substância branca encefálica e medular. A mielopatia associada ao HTLV-I (HAM/TSP) é uma doença neurodegenerativa progressiva cuja resposta imune é exacerbada. Objetivo: Avaliar o efeito da eletroterapia na musculatura do assoalho pélvico (MAP) sobre os sintomas hiperatividade detrusora em mulheres com EM e HTLV-1. Métodos: Ensaio clínico randomizado e controlado com 4 meses de acompanhamento, no qual 20 mulheres em estágio moderado de EM ou HTLV1 submetidas a um programa de treinamento da MAP associado ou não à eletroterapia. As variáveis analisadas foram: sintomas de bexiga hiperativa (BH) pelo questionário validado OAB v8, contração perineal pelo esquema PERFECT e índice de qualidade de vida por meio do questionário Qualiveen. Divididas em dois grupos, grupo controle (G2) e grupo tratamento (G1) que foi submetido a um protocolo de treinamento da MAP, realizado duas vezes por semana por 20 sessões e após este período de tempo todas as mulheres foram reavaliadas. Resultados: Sob-homogeneidade inicial observada nas variáveis pessoais e clínicas, o protocolo a que o grupo tratamento (G1) foi submetido resultou na melhora da contração voluntária (p ≤ 0,001), teste de esforço (p ≤ 0,001), reflexo cutâneo-anal (p ≤ 0,001), força de contração (p ≤ 0,001), sustentação (p ≤ 0,001), contrações rápidas (p ≤ 0,001), contrações lentas (p ≤ 0,001) e nos sintomas de bexiga hiperativa (p ≤ 0,001), em relação à comparação inicial. Os resultados comprovam a eficácia de exercícios de fortalecimento da MAP acompanhados por um fisioterapeuta e o uso de correntes eletroterápicas de média frequência para o tratamento da BH na Esclerose Múltipla e na mielopatia associada ao HTLV-1. Conclusão: O protocolo de eletroestimulação mostrou-se benéfico em pacientes com EM e HTLV-1, promovendo melhora da BH e grau de contração perineal. (AU)


Introduction: Multiple sclerosis (MS) is the most common of demyelinating diseases, characterized by multiple demyelination plaques in white brain and spinal cord. Myelopathy associated with HTLV-I (HAM/TSP) is a progressive neurodegenerative disease whose immune response is exacerbated. Objective: To evaluate the effect of electrotherapy in the pelvic floor muscles (MAP) on the symptoms of overactive bladder in women with MS and HTLV-1. Methods: Randomized, controlled clinical trial with 4 months of follow-up, in which 20 women in the moderate stage of MS or HTLV-1 performed a MAP training program associated or not with electrotherapy. The variables analyzed were: overactive bladder, validated OAB v8 questionnaire, perineal contraction by PERFECT scheme, and quality of life index using the Qualiveen questionnaire. Divided into two groups, control group (G2) and treatment group (G1) who underwent a MAP training protocol, performed twice a week for 20 sessions and after this time period all the women were re-evaluated. Results: Under initial homogeneity observed in the personal and clinical variables, the protocol to which the treatment group (G1) was submitted resulted in the improvement of the voluntary contraction (p = 0.001), stress test (p ≤ 0.001), pudendo-anal reflex (p ≤ 0.001), contraction force (p ≤ 0.001), sustentation (p ≤ 0.001), rapid contractions (p ≤ 0.001), slow contractions (p ≤ 0.001) and symptoms of overactive bladder (p ≤ 0.001) compared to the initial controle. The results demonstrate the effectiveness of MAP strengthening exercises followed by a physiotherapist and the use of medium frequency electrotherapy currents for the treatment of BH in multiple sclerosis and HTLV-1 associated myelopathy. Conclusion: The protocol of electrostimulation was beneficial in patients with MS and HTLV-1, promoting improvement of overactive bladder and degree of perineal contraction. (AU)


Subject(s)
Humans , Female , Spinal Cord Diseases , Electric Stimulation Therapy , Pelvic Floor , Multiple Sclerosis , Physical Therapy Modalities , Randomized Controlled Trial , Urinary Bladder, Overactive
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